Outbreaks

On 5 October 2014, the Ministry of Health (MoH) of Uganda notified WHO of a confirmed case of Marburg virus disease (MVD) in Kampala, Uganda.

The confirmed case was a healthcare worker who had onset of disease on 11 September 2014 while working at Mengo Hospital, Kampala. The case presented to Mpigi District Health Center on 17 September 2014, and transferred to Mengo Hospital, Kampala, on 23 September 2014. On admission the case presented with symptoms including fever, headache, abdominal pain, vomiting and diarrhoea and died on 28 September 2014.

On 6 October 2014, the World Health Organization (WHO) was informed of the first confirmed autochthonous case of Ebola virus disease (EVD) in Spain. This case represents the first human-to-human transmission of EVD outside Africa.

The case is a female healthcare worker with no travel history to West Africa but who participated in the medical care of an EVD case in a Spanish citizen, who had been infected in Sierra Leone and evacuated to Madrid, Spain on 22 September 2014 and who died on 25 September 2014. She was in contact with the repatriated EVD case twice; on 24 and 25 September 2014. On both occasions she is reported to have worn appropriate personal protection equipment (PPE).

On 30 September 2014, the National IHR Focal Point for Austria notified WHO via the European Commission’s Early Warning and Response System (EWRS) of a laboratory confirmed case of Middle-East respiratory syndrome coronavirus (MERS-CoV) infection diagnosed in Vienna, Austria. This is the first MERS-CoV case in Austria.

The case is a 29 year old female citizen of the Kingdom of Saudi Arabia (SAU), who travelled on 22 September 2014 to Vienna, Austria on a flight from Doha, Qatar. She had originally travelled from Affif, SAU, via Riyadh, by car. The case was symptomatic with an upper respiratory infection and fever prior to arrival in Austria.

On 30 September 2014, the Pan American Health Organization / World Health Organization (PAHO/WHO) was informed of the first confirmed imported case of Ebola Virus Disease (EVD) in the United States.

The case is an adult with recent travel history to West Africa who developed symptoms compatible with Ebola on 24 September 2014, approximately 4 days after arriving in the United States on 20 September 2014. The patient did not have symptoms when leaving West Africa. The case sought medical care on 26 September 2014 and was admitted into isolation on 28 September 2014 at Texas Health Presbyterian Hospital in Dallas.

On 10 September 2014, the United States of America informed the Pan American Health Organization/World Health Organization (PAHO/WHO) about an outbreak of severe respiratory illness associated with Enterovirus D68 (EV-D68). As of 16 September 2014, 130 laboratory-confirmed cases of EV-D68 have been reported in 12 US states – Alabama, Colorado, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, New York, Oklahoma, and Pennsylvania. Investigations into suspected clusters in many other states are ongoing.

EV-D68 is identified using molecular techniques at a limited number of laboratories in the USA. Enterovirus infections, including EV-D68, are not nationally notifiable, but laboratory detections of enterovirus and parechovirus types are reported voluntarily to the National Enterovirus Surveillance System, which is managed by the US Centers for Disease Control and Prevention.

Between 2 and 9 September 2014, there have been 31 more cases of Ebola virus disease (EVD) reported in the Democratic Republic of the Congo (DRC), increasing the cumulative number of cases to 62 (14 confirmed, 26 probable, and 22 suspect). In total, 35 deaths have been reported (9 confirmed and 26 probable). No deaths have been reported among suspected cases. Nine health-care workers have been diagnosed with EVD, including 7 deaths. All the cases have been localized in Jeera county. The affected villages are Watsi Kengo, Lokolia, Boende, and Boende Muke. Currently, 9 cases have been hospitalized: 4 in Lokolia; 2 in Watsikengo; 2 in Boende; and 1 in Boende Moke. A total of 386 contacts have been listed and 239 contacts have been followed-up. All cases and contacts are linked to the initial index case reported to the World Health Organization on 26 August 2014.

During a regional meeting between the Ministry of Health of DRC and the Southern African Development Community on the management and prevention of EVD transmission, the following measures were recommended: standardization of the interventions for the prevention of EVD and enhancement of sanitary border control without impeding international traffic.